PCNL和RLU治疗单侧输尿管上段嵌顿性结石的碎石效果分析  

Analysis of the Lithotripsy Effect of PCNL and RLU in the Treatment of Unilateral Upper Ureteral Incarcerated Calculi

作　　者：杨东明[1] 甘均才 杜少雄 YANG Dongming;GAN Juncai;DU Shaoxiong(Urology Department,Huizhou Traditional Chinese Medicine Hospital,Huizhou,Guangdong Province,516001 China)

机构地区：[1]惠州市中医医院泌尿外科,广东惠州516001

出　　处：《中外医疗》2021年第16期47-49,53,共4页China & Foreign Medical Treatment

摘　　要：目的探讨PCNL和RLU治疗单侧输尿管上段嵌顿性结石的碎石效果。方法便利选取2019年3月—2020年3月该院收治的68例单侧输尿管上段嵌顿性结石患者作为研究对象,随机分组,对照组(n=34)患者采取腹腔镜输尿管切开取石(RLU)法治疗,观察组(n=34)患者采取经皮肾镜取石术(PCNL)法治疗,对比两组患者手术前后血清CRP指标水平、手术相关指标情况以及并发症概率。结果观察组患者手术时长(30.8±6.1)min和住院时间(4.6±0.8)d均短于对照组[(45.3±7.2)min、(6.9±1.2)d],差异有统计学意义(t=8.960、9.299,P<0.001);观察组治疗后2、24、72 h时间段的血清CRP指标水平[(3.62±1.05)、(25.48±5.96)、(14.96±4.89)mg/L]明显低于对照组[(4.38±1.31)mg/L、(33.42±6.23)、(18.58±5.12)mg/L],差异有统计学意义(t=2.640、5.370、2.981,P<0.05);观察组住院所用花费较对照组少,差异有统计学意义(t=19.653,P<0.001);观察组术后体温超过38℃例数(2例)少于对照组(9例),差异有统计学意义(χ^(2)=5.314,P=0.021),术后结石清除率(100.00%)高于对照组(79.41%),差异有统计学意义(χ^(2)=5.733,P=0.017);血红蛋白下降值对比,组间差异无统计学意义(P>0.05)。结论RVL和PCNL法治疗单侧输尿管上段嵌顿性结石均有较好疗效,但后者治疗过程中患者创口小,恢复时间短,且安全性相对较高。Objective To explore the lithotripsy effect of PCNL and RLU in the treatment of unilateral upper ureteral incarcerated calculi.Methods 68 patients with unilateral upper ureteral incarcerated calculi admitted to the hospital from March 2019 to March 2020 were convenient selected as the research objects,and randomly divided into groups.The control group(n=34)patients underwent laparoscopic ureteral stone removal(RLU)therapy.Patients in the observation group(n=34)were treated with percutaneous nephrolithotomy(PCNL).Serum CRP index levels,surgery-related indicators,and the probability of complications were compared between the two groups before and after surgery.Results The operation time(30.8±6.1)min and the hospitalization time(4.6±0.8)d of the observation group were shorter than those of the control group[(45.3±7.2)min,(6.9±1.2)d],the difference was significant(t=8.960,9.299,P<0.001);the serum CRP index levels of the observation group at 2 h,24 h and 72 h after treatment[(3.62±1.05)mg/L,(25.48±5.96)mg/L,(14.96±4.89)mg/L]was significantly lower than the control group[(4.38±1.31)mg/L,(33.42±6.23)mg/L,(18.58±5.12)mg/L],the difference was statistically significant(t=2.640,5.370,2.981,P<0.05);the observation group spent less in hospitalization than the control group,the difference was statistically significant(t=19.653,P<0.001);the observation group had fewer cases(2 cases)than the control group(9 cases)with a body temperature over 38°C after surgery,the difference was statistically significant(χ^(2)=5.314,P=0.021),the postoperative stone clearance rate(100.00%)was higher than that of the control group(79.41%),the difference was statistically significant(χ^(2)=5.733,P=0.017);there was no statistically significant difference between the groups of the hemoglobin decrease value(P>0.05).Conclusion RVL and PCNL have good curative effects in the treatment of unilateral upper ureteral incarcerated stones,but the latter has small wounds,short recovery time and relatively safer treatment,worthy of promotion and app

关 键 词：经皮肾镜取石术 输尿管结石 腹腔镜输尿管切开取石 治疗效果 

分 类 号：R5[医药卫生—内科学]